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Clinical management of patients with drug-induced liver injury (DILI)

Clinical management of patients with drug-induced liver injury (DILI)

Title: Clinical management of patients with drug-induced liver injury (DILI)
Author: Björnsson, Einar Stefán
Date: 2021-06-28
Language: English
Scope: 6
University/Institute: Landspitali - The National University Hospital of Iceland
Department: Office of Division of Clinical Services I
Faculty of Medicine
Series: United European Gastroenterology Journal; 9(7)
ISSN: 2050-6406
DOI: https://doi.org/10.1002/ueg2.12113
Subject: Lifrarsjúkdómar; Fæðubótarefni; Lyfjanotkun; clinical management; dietary supplements; DILI; drug-induced liver injury; elevated liver enzymes; hepatitis; herb-induced liver injury; herbal; HILI; supplement; Oncology; Gastroenterology
URI: https://hdl.handle.net/20.500.11815/3120

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Björnsson , E S 2021 , ' Clinical management of patients with drug-induced liver injury (DILI) ' , United European Gastroenterology Journal , vol. 9 , no. 7 , pp. 781-786 . https://doi.org/10.1002/ueg2.12113


Drug-induced liver injury (DILI) should be considered in all patients with recent elevation of liver tests without obvious etiology and normal hepatobiliary imaging. There is currently no biomarker that is helpful in diagnosis which relies on clinical and laboratory findings. Diagnosis is dependent on temporal relationship with a recently started drug or herbal and dietary supplement and elevated liver tests with exclusion of competing etiologies. The implicated agent should be discontinued and the patient should be observed closely. This is particularly important in patients with jaundice who have approximately 10% risk of liver related mortality and/or need for liver transplantation. There is no specific therapy for DILI which is only symptomatic such as for itching. Patients with jaundice and coagulopathy usually require hospitalization.


Publisher Copyright: © 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.

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